Fatigue Quiz

Diabetes can affect many parts of the body and lead to other illnesses, but the condition can zap your energy, too. Take this quiz to see how much you know about keeping your energy level up when you have diabetes.

Q

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1. How does mental health affect fatigue in people with diabetes?A. Mood does not affect energy.B. Poor mental health may increase fatigue.C. Good mental health has no effect on fatigue.D. Mental health alters blood sugar.

2. How do infections affect fatigue in those with diabetes? More than one answer may be correct.A. Infections have no effect on fatigue.B. Infections make it more difficult to treat fatigue.C. The treatment plan may often cause or worsen fatigue.D. Infections lower the risk for fatigue.

A1.B. Mental health plays an important role in many aspects of health because it affects not only your ability to understand health-related concepts, but it also has a significant impact on your ability to engage in self-care. This includes important activities such as bathing; preparing meals and eating; checking your blood sugar; and checking your feet for infections, diabetic ulcers, and foot fungus. Some people who have diabetes experience a phenomenon known as “diabetic distress,” a condition in which a person feels overwhelmed and burned out from living with and managing his or her diabetes. Researchers found that the stress of living with and managing diabetes affected fatigue in 23 percent, or nearly one-fourth, of people who have diabetes. Also, people with diabetes are twice as likely to have depression as the general population.

2. B & C. While not all infections in people with diabetes may cause fatigue, the treatment plans used to fight these infections may increase the risk for or worsen fatigue. This is especially true when the infections involve the lower limbs of the body (i.e., the feet, ankles, and lower legs). Treating lower-limb infections and ulcers often requires the patient to reduce or avoid putting weight on the area and decrease activity. While this aspect of the treatment plan helps the leg heal, decreased physical activity and the toll taken by the infection increase the likelihood of fatigue, according to a review article.

3. True. In one in-depth analysis, tiredness was ranked fifth of the 16 most commonly reported symptoms of hyperglycemia. One study examining the effects of diabetes on a variety of symptoms in 188 Dutch patients found a slight but statistically significant correlation between HbA1c and fatigue. Another study evaluated the effects of a nighttime episode of hypoglycemia in adults with Type 1 diabetes. When subjects’ blood glucose levels were lowered to hypoglycemic levels (42–59 mg/dl) during an overnight visit and sustained in a higher range (90–216 mg/dl) during a second overnight visit, they reported more fatigue symptoms and decreased well-being and were more likely to fatigue faster during exercise than when blood glucose levels remained within the higher range. According to the authors of a review of studies evaluating diabetes and fatigue, “the successful self-management of diabetes requires physical, psychological, and cognitive tasks (e.g., exercise participation, management of hypoglycemia and hyperglycemia, and calculation of insulin doses) that are likely to be affected by fatigue. Fatigue in diabetes is likely caused from the interplay of physiological, psychological, and lifestyle-related factors. Fatigue is also likely to be both a cause and a result of poor diabetes self-management.”

4. A, B, C, D. According to the Diabetes Council, being overweight and having conditions such as sleep apnea, peripheral vascular disease, or low blood sugar all can affect your energy level. Sleep apnea is a condition in which a sleeping person suddenly stops breathing. The National Institutes of Health states that the disruption in sleep can last for several seconds and may happen as many as 30 times in one hour. People with this condition may snore or make grunting sounds, and even if they sleep continuously all night, they often wake up tired. In some cases, a condition known as peripheral vascular disease (PVD) may cause damage to blood vessels of the feet, ankles, and calves. When this occurs, these parts of the body do not receive adequate blood. PVD often occurs along with peripheral neuropathy, causes aches and pains, and may contribute to fatigue. As for low blood sugar, glucose is the brain’s primary fuel source and plays an important role in energy production for bodily cells. When the body lacks enough blood glucose to meet these demands, energy plummets. Finally, being overweight stresses the body because it has more weight to carry around than what is efficient for functioning. Therefore, it takes more energy to move, exercise and carry out normal daily tasks.

5. A, B, C, D. A growing body of evidence shows that people who exercise are less likely to feel tired, and these findings hold true not only in healthy people but also in people who have cancer and chronic conditions such as rheumatoid arthritis and high blood pressure as well as diabetes. While scientists have yet to elucidate the exact correlation between exercise and fatigue, the fact that exercise boosts the “feel-good” hormones called endorphins and helps with weight management may play a role. Fatigue is very common among people with Type 2 diabetes who have a high body-mass index. And as always, exercise also helps you to keep your blood sugar under control. As is the case with diabetes and its many potential challenges, healthy blood sugar levels are very important to staying healthy, feeling your best and taking control of your health. A healthy, diabetes-friendly diet will supply your body with many vital nutrients it needs to function and will help increase energy. Establishing a regular sleep pattern can not only shorten the time it takes to fall asleep, but also improve the quality of sleep, leading to more energy throughout the day.

Frieda Wiley, PharmD, BCGP, RPh, is a freelance medical writer and consultant pharmacist based in the Piney Woods of East Texas.

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